Counting ALL home meds on admission

[sistrmoon, BSN, RN]

We have to count all home meds on admission with 2 nurses, label each bottle with name of med, count, date, time and initials and lock them in the cabinet. Fair enough, but it's not just narcs but every aspirin, vitamin etc. I think this is a huge waste of nursing time and effort but I guess some patient accused us of stealing his non narc meds. Any other floors doing this?

[KelRN215, BSN, RN]

What kind of floor do you work on? When I worked in the hospital, we didn't do anything with patients' home meds. They weren't allowed to take their own meds while in the hospital unless there was a specific reason for it (such as, our pharmacy didn't stock that med).

[brithoover]

This may be meant as a tool to be sure there continue taking all their home meds while in hospital. We do this only the patient doesn't bring in the bottles. Just the name and dose

[VANurse2010]

[h=1]Counting ALL home meds on admission... is literally insane.[/h]

[sistrmoon, BSN, RN]

It's a med surg Onc floor. And no, after we count them they are confiscated and locked in our narc cabinet. They can't take the home med unless we have an order that states they can do so and we've filled put a sheet identifying the med. the only time we do that is if it isn't stocked. People aren't supposed to being their meds in but inevitably show up with pillowcases full of them. The only reason we are doing this is as proof that we aren't stealing/losing any meds that they bring in.

[sistrmoon, BSN, RN]

What kind of floor do you work on? When I worked in the hospital we didn't do anything with patients' home meds. They weren't allowed to take their own meds while in the hospital unless there was a specific reason for it (such as, our pharmacy didn't stock that med).[/quote']

So, you didn't confiscate them? How did you keep the patients from taking them then? And maybe accidentally doubling up on doses(their med and the ones administered by the hospital.)

[sistrmoon, BSN, RN]

This may be meant as a tool to be sure there continue taking all their home meds while in hospital. We do this only the patient doesn't bring in the bottles. Just the name and dose

No, we have a home med reconciliation tool for that and people will often bring in lists. They aren't supposed to bring in the actual meds but they inevitably do.

[Kay28]

All home meds at my hospital get sent to be stored in the pharmacy. We only count the narcotics, then just have to list the names of the others. After discharge pts pick up the meds from pharmacy.

[applewhitern, BSN, RN]

My hospital requires the patient to bring in their bottles, all of them, and we nurses have to list them in the computer for the doctor. If they don't bring in their bottles, we have to get a family member to go home and get them, bring them in, and as a last resort, call their pharmacy and have them fax us a list. The point is that we have to see the bottles. Then we tell the family to take them back home. If there is no family member, we lock them up but only count the narcotics. Getting a complete and accurate list of home meds is a headache in itself; can't imagine having to count every little pill.

[Emergent, RN]

Management and regulatory agencies keep piling on more and more tasks like this. They are usually reactionary in nature, stemming from an incident that left the hospital legally vulnerable. Or they are based on an evidence based study that failed to factor in the reality of the limitations of time.

Time spent on another checklist, counting pills, multiple screenings, checks and double checks, is like death by a thousand cuts. It eats away at patient care time. It deadens the caregivers to the value of the task, but instead they with click through so they don't get dinged by the Joint Commission chart reviews, so they can go answer that call light, round on patients, tend to real needs.

[KelRN215, BSN, RN]

So, you didn't confiscate them? How did you keep the patients from taking them then? And maybe accidentally doubling up on doses(their med and the ones administered by the hospital.)

Nope, never confiscated them. This was in pediatrics. We told the parents upon admission "we give all meds here." I never had an issue (not once) with someone being double dosed. There were a few rare occasions when the parents would take it upon themselves to give their supply (usually on the day of admission when the resident was slow to enter the orders and it was taking hours for the pharmacy to deliver) but they always told us and then we would tell them "don't do that again" and that was that.

I never had my own meds confiscated in the hospital either.

[sistrmoon, BSN, RN]

All home meds at my hospital get sent to be stored in the pharmacy. We only count the narcotics then just have to list the names of the others. After discharge pts pick up the meds from pharmacy.[/quote']

That's a good system. I doubt pharmacy likes it much though.